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Quilted bedcovers are generally divided into three main groups: whole-cloth quilts, usually sewn so the top formed a continuous pattern; pieced quilts; and appliqué quilts. Both pieced and appliqué quilts are frequently referred to as patchwork.

During the late seventeenth and early eighteenth centuries, the American desire for imported East Indian printed cotton fabrics reflected the influence of English taste. Ships of English and Dutch trading companies returned from the East to English seaports, laden with block-printed cottons in vibrant colors. Many of these fabrics reached the American colonies, where textile manufacture had been discouraged—and for some time actually forbidden—by the mother country. These imported fabrics and, by the end of the eighteenth century, American-made printed cottons, were used for making whole-cloth spreads. Soon after the turn of the nineteenth century, mass-produced roller-printed “factory goods” made in American mills greatly reduced the cost of printed fabrics and increased the number of patterns available to the middle-class homemaker.

Pieced quilts were often considered utilitarian and represented the everyday bedcover. However, piecework often produced stunning, even astonishing, geometric designs. The technique of piecework made it posible to achieve an almost endless variety of patterns. The quilts were fashioned by sewing small bits of fabric together to form an overall patterned top. The designs were often contained within a series of blocks or patches that could be more easily worked; the blocks were later joined to form the quilt top. After a quilt top was completed, it was combiend with an inner lining of cotton or wool and a backing, and stitched together.

The appliqué technique involves sewing a piece cut from one fabric—for example, a motif cut from the exotically designed and expensive palampores and chintz fabrics imported from India and England—onto a ground fabric, such as an individual block, or directly onto the full-sized background fabric. The blank areas in between the appliqués were usually quilted in decorative patterns, and in some instances part of the quilting patterns were stuffed with cotton to give a third dimension to the quilt top.

As daily life became easier for the American woman and many necessities could be purchased from a store instead of produced by hand at home, leisure time increased. No longer was it necessary for quilts to be purely utilitarian, and a quiltmaker could now concern herself more with the decorative aspects of her handiwork. This decorative aspect reached its zenith with the Crazy quilt, popular during the last part of the nineteenth and beginning of the twentieth centuries. Called “crazy” because of their randomly shaped pieces, which are believed to resemble "crazed" porcelain, it is hypothesized that the fad for these textiles was inspired by an American interest in Japanese goods that began at the Philadelphia Centennial Exposition in 1876. Often, Crazy quilts are not technically quilts at all, as they not actually quilted together—the tops and backings are frequently joined by knots. The small size of may Crazy quilts indicates that they probably were not used on beds, more more often ended up as parlor throws or lap robes. They are usually elaborately decorated with a combination of silk, velvet, and other fabrics mixed with embroidery, patches of fabric in the shapes of butterflies, flowers, birds, or other animals, and bits and pieces of material saved from a special garment.

Variations of the quilting tradition were also developed by some ethnic and social groups, such as the Amish in Pennsylvania and in the Midwest. Their textiles are distinctively designed and have their own palettes and quilting motifs—typically conservative in design and adhering to simple geometric patterns executed primarily in solid-colored wool. The Midwestern examples exhibit a greater range and complexity of design because the quiltmakers tended to be more influenced by their non-Amish neighbors, and cotton was the preferred material.

There are five main types of American coverlet: the geometric patterned plain weave, the overshot, the double-weave, the “summer and winter,” and the fancier Jacquard. The earliest coverlets were probably brought from Europe as household goods; when they wore out, they were replaced by pieces of domestic production. Two- and four-harness looms were made of hand-hewn logs and used in homes in the late eighteenth and early nineteenth centuries, but patterns requiring more than four shafts were largely the domain of the professional weaver. It was once believed that the professional weaver traveled from town to town, bringing his loom with him. However, it has now been determined that the looms were too bulky to be broken down and reassembled frequently. It is more likely that the weaver, if he did travel, did so to collect the housewives’ spun wool, which he then carried back to his shop, The housewife selected patterns from a weaver's pattern book, so that the finished effort was a collaborative product between the weaver and his client. In some other instances, a weaver might use a loom that was kept assembled in the community he visited.

The Jacquard attachment, with its series of punched cards, dramatically altered the production of coverlets after its introduction to America in the mid-1820s. This device allowed the professional weaver to create non-geometric patterns quickly and easily, without an assistant, and made coverlets available to a much greater population, The cost involved in creating such a bedcover, however, still kept them in the realm of luxury items for most households.

Watch a short video on quilt patterns by Gayle Thomas produced by the National Film Board of Canada.